Grey Lit: Lessons from California’s Health Reform Efforts for the National Debate - Len M. Nichols with Peter Harbage and Leif Wellington Haase

Posted by CHPRE Staff Publications Saturday, March 1st, 2008

Summary:

In January 2007, Governor Arnold Schwarzenegger unveiled a comprehensive health care plan that aimed to provide quality, affordable health insurance to all Californians. Based on individual responsibility, the plan focused on prevention and wellness and emphasized a shared responsibility approach to financing.

After almost a year of negotiations between Governor Schwarzenegger and Democratic legislative leaders, compromise legislation with a framework and goals similar to the governor’s original proposal passed the State Assembly with a large majority. This compromise legislation, however, was later rejected by the California Senate’s Health committee.

The effort to reform California’s health care system faced several obstacles unique to the state. Californians seeking reform had a very narrow margin of error within a complex set of legislative, political, and demographic challenges. Health reform proponents also encountered several systemic roadblocks regarding affordability and sustainability common to health care reform proposals generally.

Nonetheless, the bipartisan spirit displayed by Governor Schwarzenegger and Assembly Speaker Núñez showed that Republicans and Democrats can work together to solve our nation’s challenging health care crisis and proved that lawmakers can reach consensus without compromising core values. This bipartisan effort to cover all Californians united a broad coalition of advocates representing citizens, patients, workers, employers large and small, hospitals, insurers, and politicians.

While comprehensive health reform legislation was never signed into law, efforts to reform California’s health system produced a number of lessons for the national health care debate and other states seeking to institute reforms. Among the most important: leadership matters, broad coalitions can be built and maintained, and the issues of affordability for families and sustainability for taxpayers must be satisfactorily addressed.

“Lessons from California’s Health Reform Efforts for the National Debate,” New America Foundation (March 2008), with Peter Harbage and Leif Wellington Haase.

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